Sports-related concussion management: A functional approach

When a collegiate softball player digs their feet into the batter’s box, they have, on average, less than half a second to decide if they will swing their bat—often by attempting to read the spin of a pitch—estimating the projected end location of the ball and determining the precise moment to swing. When a quarterback takes the snap of a football, they are tasked with recalling the play call, visually scanning the field for an open receiver, and then attempting to complete a perfect pass while keeping track of looming defensive linemen. Beyond the physical and cognitive demands of completing these skills, each of these individuals have unique personal factors, client factors, and performance patterns that support or inhibit participation in their sport. Although engaging in the occupation of sport itself can be taxing on an individual, participation can be further complicated by interjecting the factor of injury—especially concussion. Concussions can result in a range of symptoms, such as headache, postural instability, fatigue, slowed processing speed, and depression that can impact an athlete’s ability to engage in their sport. Playing a sport, especially at the collegiate and professional levels, is a complex and multifaceted occupation with intense demands on one’s cognitive, physical, and mental abilities. And yet, occupational therapy practitioners (OTPs) are often not included on primary rehabilitation teams for student athletes who have sustained a concussion. OTPs are poised to play a critical role on concussion management teams to safely return student athletes to their occupation of sport by considering rehabilitation that is holistic, functional, and individualized to the athlete and their sport.